1514`r NOTE.,
With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water, mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE: August 13, 1992
LOCATION OF CONSTRUCTION Lalzuna De La Paz
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Leveling of stockpiled
material.
DESCRIPTION OF CONSTRUCTION
DIMENSION OF,INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED N/A
APPROXIMATE TIME WHEN WORK WILL BEGIN 8/14/92
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
SEE ATTACHED CONDITIONS.
t , 92 14
9
41 i30..0�)
APPROXIMATE TIME OF COMPLETION 8/14/82
ESTIMATED CONSTRUCTION COST $ 200.00 y'4
(Including'removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
i
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and•all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application.
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started.
Comply with all applicable', City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of this work.
Sig ture of Applicant or Agent
James E. Simon Co. P.O. 10990 Indio, CA 347-5399
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
521795 Exp. 12/31/93 1217 Exp. 12/31/92
Contractor's License No. City Business License No.
St.• Paul Fire tAW000160 Exp. 3/1/93
Applicant's Insurance Company Policy Number
•R
FEES: Subdivision Improvement Permit — Class III
-Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule 1514
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
$ 120.00
10.00
$ 4w= 130.00
Date
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
1514
8/13/92
EXPIRATION DATE 8117192
DATE ISSYtD 8113/92
By
Administrative Authority
TELEPHONE: (619) 564-2246
SPECIAL CONDITIONS --PERMIT NO. 1514
The following conditions shall be met to the satisfaction of the
City Engineer.
1. Permittee shall submit to the city for approval a permanent
erosion control plan for the entire -area to be disturbed.
2. Permittee shall be responsible for providing continuous dust
and erosion control. Permittee shall provide to the city name/s
and phone number/s of individual/s responsible for maintaining
fugitive dust control after hours, weekends, holidays,.etc.
3. Streets shall be kept clean. They shall be completely
cleaned at the end of the working day and more frequently if
required.
4. Contractor shall comply with the local noise ordinance.
Operation and maintenance of equipment within one half mile of
human occupancy shall be performed only during the time periods
as follows:
October 1st to April 30: Monday -Friday 7:00a.m..-5:30p.m.
Saturday, 8:00a.m.-5:00p.m.
May 1st to September 30: Monday -Friday 6:00a.m.-7:00p.m.
Saturday 8:00a.m.-5:00p.m.
Work shall be prohibited anytime on Sunday and federal
holidays.
5. Permittee shall assume responsibility for repair of any
pavement breakdown at the haul road access to any public or
private street and for any damage to other City streets or
facilities.
6. Any on-site haul road shall be effectively destroyed at the
conclusion of the work to prevent use by unauthorized vehicles.
7. Prior to the grading operation permittee shall pre -water the
area to be leveled to prevent airborne dust..
8. Permittee shall provide -to the city for approval a grading plan
if area to be graded deviates significantly from the original
approved grading plan.